Prepregnancy Counseling Among U.S. Women With Diabetes and Hypertension, 2016–2018

Marshall, Cassondra; Huma, Zille; Deardorff, Julianna; Britton, Laura E.

doi:10.1016/j.amepre.2021.03.021

Cited by 14 publications

(14 citation statements)

References 38 publications

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“…However, only 14% of ambulatory visits in the United States include any preconception or contraceptive counseling. Among women at particular risk of increased pregnancy‐related morbidity, including those with a recent birth who had diabetes, hypertension, or both prior to becoming pregnant, fewer than half report receiving preconception health counseling 3,4 . Additionally, low‐income women are more likely to receive reproductive health services in primary care (vs. dedicated women's health settings) and are disproportionately cared for in federally qualified health centers (FQHCs) 5,6 .…”

Section: Introductionmentioning

confidence: 99%

Preconception, Interconception, and reproductive health screening tools: A systematic review

Ren

Shireman

VanGompel

et al. 2023

Health Services Research

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Objective To identify and describe the standardized interconception and preconception screening tools for reproductive health needs that are applicable in general outpatient clinical practice. Data Sources and Study Setting This systematic review identifies research on pregnancy intention screening and counseling tools, and standardized approaches to preconception and interconception care. We focus on tools designed for clinical settings, but also include research tools with potential for clinical implementation. These tools may include a component of contraceptive counseling, but those focusing solely on contraceptive counseling were excluded. Data were collected from studies done in the United States between January 2000 and March 2022. Study Design We performed a systematic literature search to generate a list of unique tools, assessed the quality of evidence supporting each tool, and described the peer‐reviewed clinical applications of each. We used the Mixed Methods Appraisal Tool to appraise the quality of individual studies. Data Collection/Extraction Methods We searched PubMed, Web of Science, and CINAHL databases for standardized preconception and interconception health screening tools published in English from January 2000 through March 2022. We used keywords “preconception care,” “interconception care,” “family planning,” “contraception,” “reproductive health services,” and “counseling.” Utilizing the Preferred Reporting Items for Systematic Reviews guidelines, we screened titles and abstracts to identify studies for full text review. Principal Findings The search resulted in 15,399 studies. After removing 4172 duplicates, we screened 11,227 titles/abstracts and advanced 207 for full‐text review. From these, we identified 53 eligible studies representing 22 tools/standardized approaches, of which 10 had evidence from randomized clinical trials. These ranged widely in design, setting, and population of study. Conclusions Clinicians have a choice of tools when implementing standard reproductive screening services. A growing body of research can inform the selection of an appropriate tool, and more study is needed to establish effects on long‐term patient outcomes.

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Section: Introductionmentioning

confidence: 99%

Preconception, Interconception, and reproductive health screening tools: A systematic review

Ren

Shireman

VanGompel

et al. 2023

Health Services Research

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“…These fragmented services affect women’s knowledge of the importance of using effective contraception and the risk of becoming pregnant until they have controlled chronic conditions. Bangladesh should prioritize initiatives to ensure contraception counselling and distribution as part of diabetes and hypertension management care [ 40 – 42 ].…”

Section: Discussionmentioning

confidence: 99%

Pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension: findings from Bangladesh Demographic and Health Survey

Khan

Islam

2022

BMC Women's Health

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Background The prevalence of chronic conditions such as diabetes and hypertension is increasing among reproductive-aged women in Bangladesh. However, the pattern of contraceptive use among this population remains unknown. We, therefore, explored the pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension in Bangladesh. Methods We extracted and analysed data of 3,947 women from the 2017/18 Bangladesh Demographic and Health Survey. Women’s pattern of contraceptive use was our outcome variable. We first classified the contraceptive using status as no method use, traditional method use (periodic abstinence, withdrawal, other traditional) and modern method use (pill, intra-uterine device, injections, male condom, female sterilization, male sterilization). We later classified these as (i) no contraceptive use vs any contraceptive use, (ii) traditional method or no use vs modern method use, (iii) traditional method vs modern method use. The explanatory variables were diagnosis of diabetes only, hypertension only or both diabetes and hypertension. The multilevel Poisson regression with robust variance was used to explore the associations. Results The overall prevalence of contraceptive use was 68.0% (95% CI 66.3–69.7). The corresponding prevalences were 69.4% (95% CI 61.8–76.1) in women with diabetes only, 67.3% (95% CI 63.5–70.9) with hypertension only, and 62.0% (95% CI 52.8–70.4) in women having both diabetes and hypertension. The prevalence of modern methods of contraceptive use was lower (46.4%, 95% CI 37.4–55.6) and traditional methods use was higher (16.6%, 95% CI 13.8–16.8) in women who had both diabetes and hypertension than in women who did not have these conditions. The fully adjusted regression model showed that the prevalence of traditional method use was 31% (Prevalence ratio: 1.31, 95% CI 1.02–2.01) higher in women having both diabetes and hypertension compared with their counterparts who had none of these conditions. Conclusion In Bangladesh, women with both diabetes and hypertension were more likely to use traditional contraception methods. These women are likely to experience increased risks of unwanted pregnancies and associated adverse maternal and child health outcomes. Targeted policies and programs should be undertaken to promote modern contraceptive use among women living with both chronic conditions.

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“…38 Additional studies have shown that less than half of women with pre-pregnancy diabetes and/or hypertension received recommended counseling prior to conception. 39 Compounding the issue is that many reproductive-age women with diabetes or hypertension lack optimal management of these chronic conditions. 40 The Centers for Disease Control and Prevention has published guides encouraging physicians and health departments to partner with pharmacists to prevent and control chronic disease.…”

Section: Innovative Care Opportunitiesmentioning

confidence: 99%

“…A recent systematic review regarding health‐related needs among women with non‐communicable chronic conditions found gaps in preconception health information and desires for improved preconception health discussions with health care professionals 38 . Additional studies have shown that less than half of women with pre‐pregnancy diabetes and/or hypertension received recommended counseling prior to conception 39 . Compounding the issue is that many reproductive‐age women with diabetes or hypertension lack optimal management of these chronic conditions 40 …”

Section: Innovative Care Opportunitiesmentioning

confidence: 99%

Promising practices and pockets of excellence: Community pharmacists supporting wellness for reproductive‐age women

Mager

Bright

2022

Health Services Research

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Prepregnancy Counseling Among U.S. Women With Diabetes and Hypertension, 2016–2018

Cited by 14 publications

References 38 publications

Preconception, Interconception, and reproductive health screening tools: A systematic review

Preconception, Interconception, and reproductive health screening tools: A systematic review

Pattern of contraceptive use among reproductive-aged women with diabetes and/or hypertension: findings from Bangladesh Demographic and Health Survey

Promising practices and pockets of excellence: Community pharmacists supporting wellness for reproductive‐age women

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